Equipment Lease Application
ABOUT YOUR BUSINESS
LESSEE (EXACT LEGAL NAME) DBA STREET ADDRESS CITY STATE ZIP TELEPHONE NO.
(
LOCATION OF EQUIPMENT CITY STATE ZIP FAX NO.
) )
(
TYPE OF BUSINESS GROSS ANNUAL SALES YEARS IN BUSINESS YEAR UNDER CURRENT OWNER
FEDERAL TAX ID NO. (IF ANY)
STATE OF INCORPORATION
PROPRIETORSHIP
YOUR WEBSITE ADDRESS
CORPORATION
PARTNERSHIP
CONTACT EMAIL ADDRESS
LLC
COUNTY WHERE EQUIP LOCATED
YOUR BUSINESS OWNERSHIP
PRINCIPAL #1 NAME STREET ADDRESS TITLE % OWNERSHIP YRS OF INDUSTRY EXPERIENCE SOCIAL SECURITY NO.
CITY STATE ZIP
)
HOME TELEPHONE NO.
(
PERSONAL ANNUAL GROSS INCOME (Not including spouse) Home Owner ?
PRINCIPAL #2 NAME STREET ADDRESS
TITLE
% OWNERSHIP
YRS OF INDUSTRY EXPERIENCE
SOCIAL SECURITY NO.
CITY STATE ZIP
)
HOME TELEPHONE NO.
(
PERSONAL ANNUAL GROSS INCOME (Not including spouse) Home Owner?
YOUR BUSINESS BANK
BANK NAME CONTACT NAME CITY CURRENT CHECKING BALANCE ACCOUNT UNDER NAME OF CHECKING ACCOUNT NO. SAVINGS ACCOUNT NO. LOAN NO. TELEPHONE NO.
(
)
EQUIPMENT DETAIL
ITEM DESCRIPTION COST DELIVERY DATE NEEDED
DESIRED TERMS
LEASE TERM IN MONTHS
24
PURCHASE OPTION
36 10%
48 FMV
60
$1
The undersigned individual who is either a principal, a personal guarantor or a sole proprietorship of the credit applicant, recognizing that his or her individual credit history may be a factor in the evaluation of the credit history of the applicant, hereby consents and authorizes I-Trust Financial Group or its designee the use of a consumer credit report on the undersigned, from time to time as may be needed. Additionally, this authorization include release of any bank and/or trade information to Innovative Lease.
DEALER NAME
EQUIPMENT DEALER
PHONE NUMBER
CONTACT
X
AUTHORIZED SIGNATURE DATE
DEALER EMAIL
ADDITIONAL INFORMATION
If the business has been in operation under present ownership for less than two years, or equipment cost exceeds $75,000 please provide: *Financial Statements or Tax Returns on Company for most recent two years and most recent Interim Financial Statement.
Fax completed application to: ATTN: FAX: TEL : (781) 241-4645 (617) 241-5123
Please include an itemized quote, if available.
ECOA NOTICE: If your application for business credit is denied, you have the right to a written statement of the specific reasons for the denial. To obtain the statement, please contact Credit Administrator, (617) 241-5123 within 60 days from the date you are notified of our decision. We will send you a written statement within 30 days of receiving your request. The Federal Equal Credit Opportunity Act prohibits creditors from discriminating against credit applications on the basis of race, color, religion, national origin, sex, marital status, age (provided the applicant has the capacity to enter into a binding contract); because all or part of the applicant’s income derives from any public assistance program or because the applicant has in good faith exercised any right under the Consumer Credit Protection Act. The federal agency that administers compliance with this law concerning this creditor is the Federal Trade Commission, Equal Credit Opportunity, Washington, D.C. 20580
I-Trust Financial Group
89 Cambridge St., Charlestown, MA 02129
www.itrustonline.com